N.J. Admin. Code § 8:43G-6.8

Current through Register Vol. 56, No. 23, December 2, 2024

Section 8:43G-6.8 - Anesthesia supplies and equipment; patient monitoring

(a) An in-circuit oxygen analyzer shall monitor the oxygen concentration within the breathing circuit, displaying the percent oxygen of the total mixture, for all patients receiving general anesthesia.

(b) A respirometer (volumeter) measuring exhaled tidal volume shall be used whenever the breathing circuit of a patient under general anesthesia allows.

(c) The body temperature of each patient under general or major regional anesthesia lasting 45 minutes or more shall be continuously monitored and recorded at least every 15 minutes.

(d) Pulse oximetry shall be performed continuously during administration of general anesthesia, regional anesthesia, and conscious sedation at all anesthetizing locations, unless such monitoring is not clinically feasible for the patient. Any alternative method of measuring oxygen saturation may be substituted for pulse oximetry if the method has been demonstrated to have at least equivalent clinical effectiveness.

(e) End-tidal carbon dioxide monitoring shall be performed continuously during administration of all general anesthesia, unless such monitoring is not clinically feasible for the patient.

(f) An electrocardiogram monitor shall be used continuously on all patients receiving general anesthesia, regional anesthesia, or conscious sedation at any anesthetizing location.

(g) Blood pressure, pulse rate, and respirations shall be determined and charted at least every five minutes for all patients receiving anesthesia at any anesthetizing location, except for local anesthesia and minor regional blocks.

(h) The capacity for invasive monitoring of arterial pressure shall exist within the operating suite.

(i) A difficult airway container or cart shall be immediately available in each anesthesia department for handling emergencies. The following items are required for inclusion in the difficult airway container or cart: resuscitation equipment, emergency drugs, a laryngeal mask airway, or other items of similar technical capability.

(j) A precordial stethoscope or esophageal stethoscope shall be used when indicated on each patient receiving anesthesia. If necessary, the stethoscope may be positioned on the posterior chest wall or tracheal area.

(k) A peripheral nerve stimulator shall be available in any anesthetizing location in which patients receive general or regional anesthesia to monitor the patient's extent of muscle paralysis from muscle relaxants. Another peripheral nerve stimulator shall be available within the postanesthesia care unit.

(l) Monitoring of regional labor analgesia shall include: documented temperature, pulse, respiration, blood pressure and oxygen saturation until the patient is deemed stable based on written criteria established by the department of anesthesia. The patient shall be monitored subsequently in accordance with hospital protocol.

(m) Supplemental oxygen and a delivery system appropriate to the patient's condition shall be immediately available for patient transport from the operating room to the postanesthesia care unit.

N.J. Admin. Code § 8:43G-6.8

Amended by R.1991 d.451, effective 8/19/1991, operative October 15, 1991.
See: 22 N.J.R. 3470(a), 23 N.J.R. 2527(a).
Recodified from section 6.7. In (c), added "general or regional". In (d), deleted "all anesthesia, including intravenous, when technically feasible" and added "general anesthesia, regional anesthesia and conscious sedation unless monitoring not clinically feasible". In (e), deleted "when technically feasible" and added "unless monitoring not clinically feasible". In (f), added "regional anesthesia or conscious sedation". In (j), deleted "within the operating suite" and added "in any anesthetizing location in which patients receive general or regional anesthesia". Deleted old (k).
Amended by R.2003 d.57, effective 2/3/2003.
See: 34 N.J.R. 232(a), 35 N.J.R. 865(a).
Rewrote (c) and (g); added a new (i) and recodified existing (i) and (j) as (j) and (k); added a new ( l) and (m).
Amended by R.2011 d.055, effective 2/22/2011.
See: 42 N.J.R. 1774(a), 42 N.J.R. 2561(a), 43 N.J.R. 401(b).
In ( l), deleted a comma following "pressure", and substituted "department" for "Department" and "anesthesia" for "Anesthesia".